A Delhi consumer commission has ordered Oriental Insurance Company to pay a total of Rs 2.24 lakh to a woman after it rejected her health insurance claim on the ground that her hospitalisation was not medically necessary, a position the court found to be without basis.
The complainant, Shivani Tomar, a resident of Ghaziabad, had been covered under a health insurance policy with Oriental Insurance since November 2010. She was admitted to Max Healthcare Hospital in Vaishali, Ghaziabad, on 25 November 2023 after experiencing chest heaviness, palpitations, breathlessness, severe abdominal pain, nausea, a throbbing headache, and low blood pressure.
